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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/21712

Title: The impact of non-financial and financial encouragements on participation in non school-based human papillomavirus vaccination: a retrospective cohort study
Authors: Lefevere, Eva
Hens, Niel
De Smet, Frank
Beutels, Philippe
Issue Date: 2016
Publisher: SPRINGER
Citation: EUROPEAN JOURNAL OF HEALTH ECONOMICS, 17 (3), p. 305-315
Abstract: Adolescent vaccination coverage under a system of non school-based vaccination is likely to be suboptimal, but might be increased by targeted encouragement campaigns. We analysed the effect on human papillomavirus (HPV) vaccination initiation by girls aged 12-18 of two campaigns set up in Flanders (Belgium) in 2007 and 2009: a personal information campaign and a combined personal information and financial incentive campaign. We analysed (objective) data on HPV vaccination behaviour from the National Alliance of Christian Mutualities (NACM), Flanders' largest sickness fund. We used z-scores to compare the monthly proportion of girls initiating HPV vaccination over time between carefully selected intervention and control groups. Separate analyses were done for older and younger girls. Total sample sizes of the intervention (control) groups were 221 (243) for the personal information campaign and 629 (5,322) for the combined personal information and financial incentive campaign. The personal information campaign significantly increased vaccination initiation, with older girls reacting faster. One year after the campaign the percentages of vaccination initiation for the oldest girls were 64.6 and 42.8 % in the intervention and control group, respectively (z = 3.35, p = 0.0008); for the youngest girls the percentages were 78.4 and 68.1 % (z = 1.71, p = 0.09). The combined personal information and financial incentive campaign increased vaccination initiation among certain age groups. One year after the campaign the difference in percentage points for HPV vaccination initiation between intervention and control groups varied between 18.5 % (z = 3.65, p = 0.0002) and 5.1 % (z = 1.12, p = 0.26). Under a non school-based vaccination system, personal information and removing out-of-pocket costs had a significant positive effect on HPV vaccination initiation, although the effect substantially varied in magnitude. Overall, the obtained vaccination rates remained far below those realised under school-based HPV vaccination.
Notes: [Lefevere, Eva] Univ Antwerp, Herman Deleeck Ctr Social Policy, St Jacobstr 2, B-2000 Antwerp, Belgium. [Hens, Niel] Hasselt Univ, Ctr Stat CenStat, Diepenbeek, Belgium. [Hens, Niel; Beutels, Philippe] Univ Antwerp, Ctr Hlth Econ Res & Modelling Infect Dis, Vaccine & Infect Dis Inst, WHO Collaborating Ctr, B-2020 Antwerp, Belgium. [De Smet, Frank] Natl Alliance Christian Mutual, Brussels, Belgium. [De Smet, Frank] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Occupat Environm & Insurance Med, Leuven, Belgium. [Beutels, Philippe] Univ New S Wales, Sch Publ Hlth & Community Med, Sydney, NSW, Australia.
URI: http://hdl.handle.net/1942/21712
DOI: 10.1007/s10198-015-0680-2
ISI #: 000373140800007
ISSN: 1618-7598
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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